Organization
NORTHLAKE PEDIATRIC CARE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL BORJA MD (OWNER)
(704) 871-2323
Entity
Organization
Contact information
Practice address
2117 SIMONTON RD, SUITE 402, STATESVILLE, NC 28625-8206
(704) 871-2323
(803) 619-2149
Mailing address
2117 SIMONTON RD, SUITE 402, STATESVILLE, NC 28625-8206
(704) 871-2323
(803) 619-2149
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1002P
BCBS OF NC
NC
01
—
34D1014813
CLIA ID
—
05
—
5918872
—
NC
Enumeration date
08/20/2006
Last updated
05/30/2013
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up